A nurse is performing a neurological assessment for a client with head trauma. Which of the following assessments will give the nurse information about the function of cranial nerve II?

Instruct the client to look up and down without moving his head.

Ask the client to shrug his shoulders against passive resistance.

Observe the client's ability to smile and frown.

Have the client stand with eyes his closed and touch his nose.

Answer and Explanation

The Correct Answer is A

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Correct Answer is Hypertension primary cause b.,Hemorrhagic Stroke Symptoms progress over time b,.Hemorrhagic Stroke Rapid progression of symptoms, c.Ischemic Stroke Most common type ,c.Ischemic Stroke Symptoms resolve ,a.Transient Ischemic Attack Associated with high risk of stroke ,a.Transient Ischemic Attack Atrial fibrillation primary cause, c.Ischemic Stroke

No explanation

A. bruising over the cheek B. missing teeth C. discoloration behind the left ear D. Bleeding from the nose

Correct Answer is C

Explanation

Bruising over the cheek is a sign of facial trauma, not basilar skull fracture.

Missing teeth is a sign of dental injury, not basilar skull fracture.

Discoloration behind the left ear, also known as Battle's sign, is a sign of basilar skull fracture, as blood accumulates in the mastoid process due to a fracture in the temporal bone.

Bleeding from the nose is a sign of nasal trauma, not basilar skull fracture.

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A nurse is performing a neurological assessment for a client with head trauma. Which of the following assessments will give the nurse information about the function of cranial nerve II?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client arrived by EMS after a bar fight. He is disoriented with a Glasgow coma scale of 10. What additional finding indicates that he has suffered a basilar skull fracture?

Correct Answer is C

Explanation

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